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Out of the Darkness, Into the Light: One Mother’s Journey Out of Postpartum Depression By Michelle Pier As a young girl growing up on Guam, I had a great fondness for family and knew that one day I’d probably have my own children. My vision of being a parent was shaped by media portrayals of what a family looks, feels and behaves like, and at the time, I did not know that we each create our own reality of what a family is. I assumed that one day, I would be happily married, with a stable income, a home, and then have children. As a teenager, I struggled with low-level depression that would come and go. Hiding this part of me had become my specialty. Most people would have described me as a generally upbeat and positive person who seemed to bounce back from just about anything. It seemed as though that was just who I was, that I would always be on-and-off depressed, wallowing in self-pity, while feeling angry and resentful toward the world. It never occurred to me that I was unconsciously making the choice to be depressed about what ever it was I felt that way about. It never occurred to me that if I did not want to feel that way, only I could make the changes to allow my happiness. During my senior year of high school, I was involved in a relationship that ended in drug-related domestic violence. I learned a lot about strength and humility, and what I did and did not want in a relationship. Certain standards that were held had been broken down, and new ones built. My true sense of worth was gradually evolving. Not too long after, I was in another serious relationship. In retrospect, I don’t think I had given myself enough time to rediscover my true self before jumping into another codependent partnership. Taking a huge risk, I left my life and family on Guam to move to California with my partner and attend school there. Less than a year later, we discovered that I was pregnant with our first child. At the time, I was overjoyed, fearless, and yet terrified all at the same time. I thought to myself, “What am I thinking? I’m so young! I don’t have experience with babies, but I know I can do this. It feels so right. But I’m scared.” The pregnancy was fairy uneventful, in the physical realm. Emotionally, I was a wreck. Blaming the hormones, my moods would jump all over the place. I’d be laughing and feeling giddy one moment, and then crying about something the next moment. Assuming this was normal; I didn’t think much of it at the time, except that it drove me nuts. With my tendency toward a natural approach to life, I did a lot of research, soul searching, and talking with other women about natural childbirth options. After extensive reading and communicating with other women, I made the life-changing decision to have a homebirth, without the assistance of a midwife or doctor. Few friends and family were supportive of this decision, but in my heart, I knew it was the way for my baby to come into this world. My partner was totally supportive of the decision, though he was preoccupied with the pressure to get a stable income going for our family. We struggled with unemployment, lack of communication, and we also moved to a new apartment toward the end of the pregnancy, which proved to be extremely stressful. Depression reared its head often. The birth of our first son went fairly smoothly, though there were many moments of fear, anxiety, and confusion. The labor lasted about nine hours, and Every was born into his father’s arms in the privacy of our home. I experienced some hemorrhaging, but managed it just fine by laying down, drinking a lot of fluids, and swallowing a small piece of the placenta once it was birthed (the placenta is remarkable in its ability to restore many of the nutrients and hormones that drop dramatically in the mother after its birth). My body was sore and exhausted. After the initial bliss and surrealism of the birth faded, I seemed to spontaneously fall into dramatic highs and lows of postpartum depression. At the time I did not see this at all, it seemed like normal hormonal postpartum issues. Over the next several months, things just intensified, the highs were higher, and the lows even lower. When Every was about five months old, I knew that I needed return to Guam, where I hoped the support of friends and family would improve my situation. My partner did not want to move, but reluctantly did so anyway. We arrived on Guam when Every was six months old. My parents allowed us to stay with them while we figured out what we were going to do. This was a challenging time, but things seemed hopeful. A great job opportunity came up for my partner a week after we arrived, and he took it. Fruit of the Womb, my new home-based business retailing gift baskets and cloth diapers to new moms and their families, was created in between juggling the demands of an active infant. I also got involved in helping to start a non-profit organization to provide empowering resources and information to new and expecting families. It seemed like I was finding myself again, getting back into a groove. We moved into the downstairs apartment of my grandmother’s home, and finally had our own space. Just as we were getting situated in our new residence and my new venture, we discovered that I was pregnant with our second child. This time, I felt ambivalent, wavering between excited and extremely worried about the near future. I was excited about Every having a sibling to play with, another person to love and get to know, to share a life with. However, I was even more worried about the toll it would take on my body, trying to give constant attention to a toddler while pregnant, and then even more so after the birth. Would our son have to wean before he was ready? What if he did not like the idea of a sibling, or having to share all the things he had to himself? Would I have to endure postpartum depression all over again? This pregnancy was more physically stressful than the first, and it was wearing on my mental state. Prenatal depression showed itself frequently, especially since I was still in a relatively isolated situation. I was, however, confident in my decision to birth at home again, and felt a little more prepared in that aspect! Our second baby boy, Kenneth, was born at home in the water, and his older brother witnessed the whole event. It was a relatively quick, but intense birth, but beautiful all the same. We had a quiet babymoon, but Every had a very difficult time adjusting to a new family member. It took every last ounce of patience I had to help him get through it. Even with all the precautions I took in setting up extra support to help me through the postpartum time, the wave of darkness swept over me like a heavy cloud with no wind. Some days I just did not want to be alive anymore. When Kenny was about three months old, I got a part time job waitressing, which helped a lot. I was able to distance myself from motherhood just enough to regain perspective. Unfortunately, the relationship between my partner and I was going downhill fast. Resentment was building, and miscommunications spiraled out of control. Five months later, life as I knew it came to a halt. I made the terrifying decision to end the relationship. All that I was certain about was that the environment we had created was toxic for all of us. I lost my job, and got on public assistance. This was also when I finally got serious about seeking regular therapy, as well as getting on antidepressants. All of these major changes were terrifying and liberating all at once. I was on the road to recovery. I made the conscious decision as often as I could to choose to be happy in the moment, whatever that moment had in store. At this time in my life, I would only do what I love and nothing less. This meant that I was determined to find a way to make money staying at home with the boys. I wanted to pursue my passion for art and writing, for enjoying life and spending time in nature on a daily basis. Many spiritual revelations and moments of absolute clarity reassured me that I was now on the right track, the one that felt good. It was obvious who I was on the inside and what I needed to do to stay true to myself. This did not all occur without setbacks, discouraging moments, and negative emotion. In fact, there were a lot of ups and downs, but it has been a gradual process of evolution; the evolution of my mind, body, and spirit. Now, Kenny is just over a year old and Every is just over three years old. Signs of depression emerge every once in awhile, but I am on a mission to live a life of love and joy, so the low feelings never last long. I try my best to accept the emotions that come, and not resist them. Witnessing my low moments from an objective standpoint really helps. Staying detached, free of judgment, fear, guilt, or shame is what keeps me moving forward in a positive direction. Asking myself “What do I want in this moment?” is my key to letting go of resistance. Now, I can say with full confidence and enthusiasm, that I am enjoying the evolution of my desires and watching them come to fruition on a daily basis. I accept myself for who I am, and where I am in this moment, always. Letting go of the label “postpartum depression” is so freeing. To just let myself be, without judgment, or labeling, gives me the relief to move forward without pressure or attachment to something that is not who I truly am. Looking back on the most difficult times in this journey through life, I feel nothing but compassion, love, and understanding for myself and everyone else. We are all connected, in this life together as one, and it is much easier if we just love one another for who we are, and where we each are in any given moment. We are all unique and beautiful. Peace and joy beyond all understanding to all! Essay written 10/1/08 by Michelle Pier, of Fruit of the Womb
http://fruitofthewomb.tripod.com
Live and Let Birth 5 Empowering Ways to Create the Birth Experience You Desire By Michelle Pier “When you expect something, it is on the way. When you believe something, it is on the way. When you fear something, it is on the way.” --Esther and Jerry Hicks Childbirth is a wonderfully mysterious and spontaneous rite of passage that offers a life-changing opportunity for empowerment and transformation. Love is the key ingredient to creating a joyous and peaceful birth. Birthing free of fear and pain is not only possible, but is the natural state in which we were meant to experience birth. Your body has infinite power and wisdom, and can overcome any perceived obstacle. Believe that you can birth in any way that you desire, and you are one step closer to achieving it. Here are some suggestions to help you move toward the birth experience that you desire: - What is your current vision? What images do you see when you think of birth? Do those images feel good, or do they bring about negative emotions? In order to examine our beliefs and associations surrounding birth, we must first identify them. There are many ways to do this. A very eye-opening option may be to draw or paint what “birth” looks and feels like to you, or you can simply write it out. Do what feels right. Where do you see yourself giving birth? Who is with you? Are you afraid and anxious, or are you flowing with confidence and joy? Be completely honest with yourself. Remember, no matter where you are right now, it is okay to be there, and it is essential to accept where you are now in order to move forward to where you want to be. When answering these questions, do not limit yourself. Like brainstorming, every thought counts here! Also, take as much time as you need. You may do this exercise gradually over several days, so that the thoughts can come freely and you can truly reflect on your existing beliefs about birth.
- Allow yourself to heal from past traumatic experiences that may be contributing to any limiting beliefs you may have about birth, yourself, and life in general. It is okay to let go of any pain from the past that you might be hanging on to, whether it be from a past birth experience (yours or someone else’s), or any traumatic life experience for that matter. If you could talk to the woman that you were during a painful time in your life, what would you tell her? Would you simply give her a hug and let her know that everything will be okay? Treat that woman as a dear friend, and have compassion for her. Forgive her for any actions that you feel caused her or others any pain or discomfort. Thank her for doing the best that she could with what she knew, and for any and all actions that kept her true to her inner being. Now, have that same compassion for your present self! You certainly deserve no less. Forgive and thank yourself for being who you are, and being where you are now. Your past does not dictate your future unless you allow it to. Encourage yourself to start fresh. Anything is possible when you live in this moment.
- Counter your fears with positive information that makes you feel good! For every fear or negative association that you identified in the first exercise, counter it with knowledge. If for example, you fear that you will have a long labor, you can look for encouraging tips on how to let go of whatever time constraints you or anyone else may have attached to the birth. Every birth is unique, and your body and baby know exactly what it must do to birth the way that it needs to. If you or someone else has put an arbitrary time limit on when the baby must be born, then of course any length of labor that exceeds that time will be considered “long.” Indeed, it is possible to experience a “long” labor that is not necessarily long and painful! Birth knows no time, and if you are feeling pressured, it is important to ask why. Why must you give birth at a certain time? Only you know if the answer is an acceptable one or not. Be aware of fear-based assumptions. If you are alert and paying attention, you can usually spot them because they do not feel good. Look for the information that lifts you up and gives you confidence. You can find suggestions for encouraging a smooth labor or how to let go of attachments that you may have to what birth should be like. Inform yourself about what your body does when left to birth naturally, or find out the risks and benefits of any procedure long before you agree to have it done to your body and your baby. When you are aware and informed, you need not fear the unknown.
- Rewrite your story. We all have a story, and we can change the story at any time we wish. Take what you have learned about yourself from the above exercises and now make the changes that are right for you. What is the experience that you most desire? What images make you feel good inside? Concentrate on the positives, and what you do want in this exercise. Then, list the reasons why you do believe that you can create this experience. Look for as many reasons as you can! This can be a daily practice, and you can involve others in helping you come up with more reasons why you can create the birth experience that you desire. Allow yourself to have fun with this. Seek out empowering and inspirational stories from other women, books, web sites, anywhere! Surround yourself with people who contribute to your well-being, and filter out any negative information, stories, or advice that does not make you feel good. That stuff does not serve you or your baby and will only pull you away from creating the experience you desire. You have the choice to accept or discard any thought or piece of information that comes your way. Accept those that inspire and instill peace and joy within you, and discard those that don’t. Create reminders for yourself everywhere you go, that you are a beautiful and powerful being. They can be visual, like art, collages, and the written word, or they can be audio, like inspirational talks or uplifting music. Meditation and positive affirmations are powerful ways to reconnect with your inner self. Do these things as often as you can!
- Practice the art of allowing, acceptance and detachment. Allow that which is good to flow into your experience, accept what is your experience in any given moment, and remain detached from expected outcomes. Always remember that you experience what you need to, in order to gain the wisdom that you need to evolve. As conscious creators, we can manifest whatever we desire. They key though, is to allow what we desire to come into our lives. For instance, if you desire a drug-free birth, but believe that you cannot birth without drugs, you are not allowing your desire to come to fruition. With this, we must accept what we do experience. Using the same example, if you do end up receiving drugs during labor, it serves you no good and you cannot learn and grow from the experience, if you waste energy feeling guilty or shameful about your experience. It is what it is, and you cannot change the past. What matters is the present moment, and what matters in any given moment is that you feel good, and that you are true to yourself. The art of detachment lies in trusting that by doing what your heart tells you, everything will always be as it should be. It is far easier to accept uncertainty and believe that this birth and all others serve a purpose in the grand scheme of life. Our conscious minds have but a teeny tiny piece of the puzzle, and we cannot know why certain things happen the way they do, but we can accept that what flows into our experience is right for us. Let your desires guide you toward your destination, but remember that enjoying the journey is the key to your happiness, and to a beautiful and joyous birth experience.
Article written 10/2/08 by Michelle Pier, of Fruit of the Womb http://fruitofthewomb.tripod.com
Asher Dean: A Doula's Beautiful Cesarean Birth 3/3/08 Danielle Griffin
On Wednesday the 27th, I went and saw my midwife for my weekly appointment. I was 7 days past due and thought I would have gone into labor at that point. I still felt pretty good though, and knew it was getting closer. When I got to the office, I saw my secondary midwife, and one of the students. They wanted to check my cervix to see if I had made progress from the previous week where I had been 2 cm dilated, 50% effaced, and Asher was at -1 station. When she checked me, she informed me there had been no progress from that point. I was ok with that, although a bit surprised. I had been losing bloody show for about a week (I'd never heard of anyone losing show for more than a few days) and I had been having pretty decent crampy contractions. She told me that my primary midwife wanted to do a Foley Catheter induction if I hadn't made any progress. I had never actually heard of a Foley Catheter induction (to my surprise, being that I am a doula myself). I talked it over with her. She was aware that I wanted to be as non invasive with this labor as possible, and I wanted to know the details. With a Foley Catheter, they insert a balloon into your cervix and inflate it to about 4 cm. You walk around and the pressure of the catheter causes you to begin dilating until you're a four, at which point the balloon will fall out. If it didn't work, there were no negative implications so I agreed to it. My primary midwife had to be called into the office to do the procedure. It was actually not nearly as uncomfortable as I imagined it would be. She told me that she actually hadn't had a ton of success kick starting labor with the Foley, but had heard other midwives that swear by it. I started getting crampy immediately. I had left the office with the orders to walk as much as I could so that the pressure would cause dilation. I was also told that it shouldn't be in more than six hours, and if I hadn't dilated to four after six hours to remove it. I called my partner Jake to let him know what was happening (he had stayed home with Eli- our first son- during my appointment). I drove to Home Depot to walk around and pick up a few things. I had burnt the vacuum filter earlier that day and knew if I wasn't able to finish vacuuming I'd probably be horribly embarrassed when everyone got to my house for the birth. I was having regular contractions while walking around. When I got home, I tried to wander around the house and stay upright. I watched American Idol and tried not to pay attention to my contractions. After a few hours, I was getting upset the balloon hadn't come out yet, so I went on a walk to the Red Apple about half a mile from our house and back. My contractions were getting much crampier and I was pleased. Still the balloon hadn't come out, so I took a shower and decided I would have a quick nap. Jake told me he'd wake me up at midnight and we'd see what was going on. I was supposed to take the catheter out at 11:30. At midnight I woke up and it came right out!!! My contractions weren't as regular though, and I didn't want labor to go away. Jake's best friend Tommy was sleeping in one of the rooms to keep an eye on Eli (I wasn't ready to send him away yet), so Jake and I took a walk to the river. There was a nice cool breeze and we had a really good time walking together. Contractions were crampy while we walked, but once we were back and I was sitting or lying down, they weren't as intense. I was very surprised at how easily I made it to four cm this time around, because with Eli I had horrible back labor and it took a long time and a lot of very hard contractions to get to a four. I decided then (probably 1:30 am or so?) that regardless of whether or not the contractions peter out, I needed to try and sleep because I was sure to have a full day ahead of me. I fell asleep immediately. I remember waking up to a couple contractions, and Jake swears I moaned a couple of times in the night. I slept all night though. Woke up at around 7 am the next day, Feb 28th. I wasn't feeling regular contractions and I was slightly irritated. I called my midwife and left her a message saying that the balloon came out, I was having contractions, but they weren't regular and so I wasn't getting too excited about it. I wanted Jake and Eli to sleep, so once again, I got up and walked to Red Apple to get myself a coffee and back. As soon as I started walking, my contractions got regular again. Jake and Eli were up once I got back (which was surprising to me! Jake will normally sleep as late as possible. I knew he was very excited and antsy about our new son making his arrival soon though!). Eli played around the house, Jake cleaned, and I tried to busy myself with this and that. I didn't want to sit too much because I didn't want contractions to space out. I let my doula (Megan- also my business partner) know what was happening. It was a bit funny and ironic, because she had told me the week prior that Thursday was the only day I wasn't allowed to go into labor since she wouldn't have a sitter that day! I received a call back from my midwife in the late morning/early afternoon. I told her my contractions were coming back, but they weren't horribly strong yet. She told me she wanted me to call her at 2pm regardless of what was happening, to update her. She also highly suggested I have someone come get Eli at that time. One of my best girlfriends, Xamara, came and picked him up (she got pulled over on the way to our house!) I talked to my doula at 12:30 or so in the afternoon- right after Eli was picked up. I told her we were still doing well on our own. She listened to me moan through a couple contractions. She thought that she ought to head over at that point since it's a little bit of a drive. She arrived right before 2 pm. When she got to our house, I was having a contraction in the kitchen and smelling lemon dishwasher soap (I've been in love with the smell of lemon dishwasher soap this entire pregnancy)!! We chatted between contractions and tried to keep the vibe light hearted. The sun was shining through my windows and I was in a fabulous head space to be in labor. I called my midwife back at 2, as promised. I had told her the contractions were more intense, but I felt I was really dealing with them well. She listened to me vocalize through a pretty powerful contraction and told me that she and the students would be over at 3:30. I told her I still felt I was doing well if they wanted to wait longer. She had a chat with my doula, and they thought I was making good progress and that we should get the team together. Megan and I spent time together during contractions talking and just all around trying not to focus fully on the sensations. When the team arrived, I was checked. I was 5 cm dilated and 100% effaced. She continued checking me through another contraction, and I went from a 5 to a 6. I was very enthused to hear this! I knew I was doing hard work, but it felt completely doable! My midwife suggested that Jake, Megan, and I take a walk. I was ok taking the walk, but knew it would be a bit interesting. We live in a business district, and it was a sunny afternoon- and here I am moaning through contractions! We walked about forty five minutes or so. I tried to walk through contractions, but it didn't work for long. Megan was very amused at all of the cars that leered while I was contracting in the middle of everything! Once we got back to the house, I decided I wanted to take a shower and just have Jake in the room. I think this was probably my favorite part of the labor. I stood in the warm shower, and I had Jake bring his guitar in. He played guitar and I sang while the sun was shining through the bathroom window. It was very beautiful. We sang Elderly Woman Behind a Counter in a Small Town, Mr. Jones, and Lola. The water then started getting cold and I had to get out. I was bummed the water was giving up because I was really enjoying that time with Jake and it made my contractions seem like they weren't even happening. She checked me again soon after that and said I was more than a 7, but not quite an 8 (this was around 5 pm or so). I felt like this was going so easily! The only issue we were having was that my cervix was still posterior. I labored in the living room with the midwives, Jake, and Megan. I still tried to keep the mood light and joke in between contractions. It was around 8pm now. The contractions began getting more and more difficult to cope through. I was really getting to a point where I wanted things to speed up. When I was checked again (time is now foggy), I was still about a 7. Because my cervix wasn't coming forward, Asher's head wasn't putting even pressure on it causing it to dilate further. My midwife held my cervix forward during a few contractions (Yowza!), but it wouldn't stay put. My water still hadn't broken, and I was thinking that it would be a good idea to help it along. I had been a 7-8 for a couple hours by then, and transition contractions were kicking my butt. When she broke my water, it absolutely gushed out. It was clear, no meconium staining. Contractions were the most intense I had ever felt. I wanted to go upstairs and labor with just Jake. We went up and turned on the labor music I had downloaded to our computer. I labored on my left side for quite some time. It made the contractions space out a bit, but they were even stronger. I was becoming very tired, and I fell asleep between a few contractions. It was hard, because once the contraction hit, it would wake me up and I didn't have enough time to get on top of it. I was alternating the ways I tried to cope to see what worked. I banged on the bed frame with my hand while I counted, I tried thinking of Eli and the cute things he says, nothing was working just right. I then realized that if I pushed *just a little bit* during my contractions, that it eased the pain slightly. Everyone had made it upstairs by then. I asked if it was ok to push just a little bit. I was told to go ahead, but don't push much if it's not time- and that I'd know when it was time. After a bit, I was checked again and I was still a 7. I was very irritated and disappointed. I had worked through these extreme contractions for hours, and nothing was happening. I remember thinking that transition was supposed to be the shortest part, and I was angry. I needed to get off of my left side. I went downstairs and got into the shower. I was hitting the shower wall rhythmically during contractions. Jake was in the shower with me. I kept telling Jake I couldn't do it and I didn't want to do it any longer. Jake was very strong for me, because I know it was hard for him to watch me while I was in pain like that. He told me I wasn't giving up and I had to keep going. He knew that I would be angry with him if I felt he let me give up to easily. It took me a little bit to get into the right head space and stop disagreeing with him, but I reached deep down and found every last piece of energy I had inside of me. I began to fill the bath tub with water. I thought this would be my secret weapon and allow me to get in some good contractions but still be able to relax slightly between them. There was not a ton of hot water left, so Jake began boiling pots and pots of hot water. He kept the water pretty warm for me and I am very grateful. I needed it.. I lowered my noises which had gotten very loud and screamy. They weren't helping me cope and I knew I needed to change that. I oohed and rolled my head from left to right, right to left, during contractions. I know it probably looked like they weren't too intense from the outside, but I have honestly never felt anything so all consuming before in my life. I did this for some time, but I'm not certain how long. When I was checked again, I was STILL a 7. This was around 11:30. I had been at a seven and having transition contractions for about 6 1/2 hours. My midwife said that although I could feel my contractions, they weren't affecting my cervix while I was contracting (based on what she felt during a check). She said that she felt we should transfer to the hospital for Pitocin. I was disappointed, but agreeable. I couldn't handle transition contractions unmedicated any longer, not to mention they weren't doing much of anything to my cervix. We grabbed everything and quickly left. The hospital was very close to our house, so we were there within a few minutes. We had called to tell them we were coming. They were very friendly to us when we got there. We were expecting a battle since I am a home birth vbac transfer. I told them to please have the anesthesiologist come to the room asap. I had to sign consent forms and give insurance information when we first got there. The nurses were working quickly to get a heploc inserted into my hand. Dr. Paul came in after we had been there maybe ten minutes or so (he was German? maybe and his last name was hard to pronounce, so everyone called him Dr. Paul). I asked him to give me an epidural quickly. He said something along the lines of wanting to give me a full spinal block for cesarean. I told him I was planning a vbac and wasn't needing a spinal block at this time, just an epidural. He sort of mentioned that since this is the second time I've stalled out in labor that I'd probably end up with a c- section anyway. It was a bit insensitive of him, although I understand where he was coming from. I explained to him the importance of my trying for a vbac, and we would decide at a later time if a c-section was necessary. He complied and gave me my epidural. When the OB Dr. Tan arrived, he had come on the assumption that we were here for surgery. I told him that I needed pitocin and I wanted to labor longer. He tried to talk me into a c-section, at which point I began my spiel again about the importance of a vaginal birth to me. He didn't seem very interested at first, and began to explain the reasons I ought to have a c-section right away. I finally talked him into letting me labor. I asked everyone to leave the room so Jake and I could talk. He had had a very hard time accepting the hospital transfer and then c-section with Eli, and I wanted to make sure he was holding up well. During that time, Dr. Tan came back and spoke with us. He said that he only wanted to let us labor for a couple of hours, and then if there was no cervical change, do a cesarean. I did not consent to that, but sort of told him to check back in a couple hours and we'd talk. I told him I felt I needed pitocin. He said that my contractions were two minutes apart and pitocin wouldn't be necessary. I told him they were two minutes apart, but they weren't strong enough and I did indeed need pitcon (I later joked with Megan that I never thought I'd be begging an OB for pitocin!) He said he'd like to check my cervix. His "check" took about half a second and he told me I was only a 6. I know for a fact that he didn't actually check my cervix. I have a posterior cervix and he had small hands. He didn't have to reach to grab it or anything, and even if it wasn't posterior, he couldn't have possibly measured it in the time he gave himself. He left the room. About fifteen minutes later, he returned. It was weird, it's like he thought about the things I had said to him and changed his mind or something. He said to me that he'd like to let me labor without pit for a couple of hours and measure the intensity of my contractions (thank you! That's what I was asking all along!) He said if they did not seem intense enough, that he would give me pitocin around 4 am. Sounded very fair. I fell asleep (sort of) in the next couple of hours. I don't know if it was the nerves or being in transition, but I was shaking like a leaf since before we had even gotten to the hospital. I prayed and I changed positions as best I could with an epidural. I chatted with Megan in between cat naps. Jake went home to get some things and to blow out candles (we had run out in a hurry!). He got back during my nap. I was woken up at 4 am by our new nurse who was fabulous- I believe her name was Lori. She was up to date from Dr. Tan and wanted to check me. She said I was a 6-7 and that we'd start pit. I was only allowed to have 8 somethings of pitocin ( I don't recall the measurement), but that normally they can do up to 30 on people that aren't vbacs. I tried to nap more and keep changing positions after they gave me the pit. The contractions were very hard and pushed on my ribs which made them quite sore. The Dr. came back in at 6 am to check me. He truly checked me this time because he had to reach a bit for my cervix and it took longer than a millisecond. He said I was still a 6-7 and he felt it was time for a cesarean. I sobbed and sobbed. Dr. Tan became very genuine then. He looked truly upset that I was so distressed over this. He told me he doesn't like to see his patients cry, and that he's sorry that this is happening. I think we really connected at that point, and I was glad that if I needed a c-section, that he would be doing it. Not only that, but I'm hoping that our experience together will help him understand his patients that desire vaginal births a little better. I think most patients are probably not as outspoken as me about my wants. There are so many people that don't even realize that they have a say. Then I spoke with the nurses who knew how badly I wanted a vaginal birth. Through sobs I told them about my fears from my previous cesarean. I told them about how the curtain had been up against my face and I have some claustrophobia and it frightened me. I told them about how, also because of claustrophobia, that the thought of having my arms strapped down scared me. I told them about how I can't do oxygen masks for the same reason and to use tubes instead if that was ok. I remembered how my mouth went dry immediately when I got into the OR and I wasn't allowed to have anything to drink...and I told them how a nurse that time snuck me a wet washcloth to suck on and could someone please do that for me? I also told them about how my anesthesia didn't take with my first cesarean and I could feel them cutting into me. Not only that, but everyone in the room was chatting amongst themselves and not talking to me to keep me calm and as happy as someone could be in that situation. The nurses all listened and really cared and absorbed what I said. So did the Dr. So did the Anesthesiologist. I told them about how I'd like to play music in the OR and how I'd really like for my doula, as well as Jake to come in. Their protocol is to only allow one person in the room, but they made an exception for me and allowed Megan as well. They prepped me and we went to surgery around 7:45. They knew how frightened I was, and they didn't make Jake and Megan sit outside while they got me anesthesia situated like they generally do. Dr. Paul (the Anesthesiologist) was very warm and caring and talked to me while he gave me more meds. He also mentioned that he could get in trouble for allowing them in the room while he was doing this, but it was ok because he wanted me to be comfortable. I was shaking very hard but trying to keep my head clear and allow it to be a beautiful birth anyway. I could feel the cold run down my spine every time he gave me another shot of something. He kept pinching my stomach. I went from completely feeling it, to feeling absolutely nothing. I got very anxious after each shot because of the feeling I got in my feet and legs. I didn't mind being numb that much, but there is a strange warm feeling with each injection that's a bit unsettling. Megan and Jake sat on either side of me and Megan set my birth necklace on my chest and I said a blessing. The Doctors put in my Janis Joplin cd and turned it up when I asked them to. When they cut into me, I was crying and telling Megan I couldn't feel it! I had felt everything with Eli's cesarean. When I was having a hard time concentrating and not getting anxious, I began singing to Janis. Megan sang with me. Jake looked into my eyes and held my hand. The Dr's explained what was happening and were talking with us, rather than amongst themselves. They told me we were almost there and that he was a big one! They told me how handsome he looked before he was out enough for me to see. I had to breathe through the tugging when they pulled him out. I told Jake and Megan that I was focusing on how interesting the sensations are and thinking about them as just interesting sensations that most people wont get to experience in their lives. When he was out, they let Jake cut the umbilical cord. They showed him to me over the curtain and Megan took a picture. Jake was able to sit behind me and hold him briefly, before he and Asher had to leave to recovery. I gave him kisses and told him I loved him and how beautiful he was. Jake had to leave with him while they sewed me up. I cried and told Megan how happy I was that she was there to experience that with me. She cried too. I kept asking if I was ok because I had a feeling something was a bit wrong. Everyone kept telling me I was doing fine. I did find out later that I had lost quite a bit of blood. They had to give me medication to keep me from bleeding further. They took a good long time sewing me up and did a fabulous job. I would say just about everyone in the room when we were finished came and either gave me a hug, or held my hand and told me what a great job I did and how beautiful Asher is. It was a very healing experience from my first cesarean birth. It's not exactly the birth I was dreaming of, but given the circumstances, I don't think it could have gone any better. Asher immediately knew how to nurse, and is an extremely content and handsome little boy. I now know that it's not the way you give birth that really matters, it's the way you feel about your birth that matters in the long run. It's a very humbling and eye opening lesson learned by this doula.
Epidural Anesthesia- Worth the Risk? 1/30/2008 Danielle Griffin
So you’re pregnant! It seems that one of the first things that a woman thinks about upon finding out she is pregnant is the pain of childbirth. It’s the first thing that popped into my mind when I found out I was pregnant with my first son. It seems that it is brushed aside quite easily though, once we remind ourselves that we have the option of epidural anesthesia. It’s safe, and everyone gets one, right? Wrong. If you find yourself considering an epidural, please make sure you are fully aware of all risks and side effects associated with it before committing to the decision of having one.
An epidural is a drug cocktail of opioids that is administered into the ‘epidural space’ which is a part of the spine. It causes a loss of sensation and a loss of pain by blocking the nerves near the spinal cord.
Quick Facts:
Women who receive an epidural are more likely to experience a longer labor, increasing the likelihood of them receiving pitocin to augment labor.
Pitocin highly increases the risk of the baby showing signs of distress (depressed fetal heart tones, decreased oxygen, etc) as well as possible mal-presentation, which can lead to a cesarean birth.
Epidurals increase the risk of a posterior baby not rotating (due to the mother being confined to the bed and unable to labor in different positions), which increases the risk of cesarean section.
The mother will almost certainly be given a bladder catheter which can cause bladder infection.
There is the possibility that your epidural will have ‘block failure’ leading to no pain relief whatsoever (statistics state this is a 1/20 chance).
When it comes time to push, the mother cannot feel the ‘urge’ that she would feel naturally, increasing the risk of vacuum and/or forceps extraction, as well as cesarean section.
There can be loss of function of the sympathetic nervous system, which can cause respiratory paralysis in the mother (which would also cause lack of oxygen to the baby).
Epidural has been known to cause cardiac arrest (although quite rare).
Opioids in the epidural cross the placenta and get to the baby causing it to be drowsy and disassociated following birth. This can severely disrupt the breastfeeding relationship.
All women go into motherhood with the best of intentions, and yet I see so many that do not research their childbirth. An unmedicated childbirth is an amazing and beautiful thing. It’s a rite of passage and something you will truly never forget- and not only that, it’s completely doable!!!! Women have been giving birth since the beginning of time! During an unmedicated childbirth, your body releases endorphins, which is nature’s pain killer. Your brain will also release a chemical called oxytocin (the love hormone). The release of oxytocin causes your uterus to contract, and it also initiates the bonding process with your baby. The baby being more alert after birth will help to cement the breastfeeding relationship more quickly which helps with bonding. Oxytocin and endorphin production are blocked when you receive medication.
On the flip side of things, there is a time and a place for epidural anesthesia in my opinion. I believe if a laboring mother is at a point where she is exhausted from a very long and drawn out labor, an epidural may be what she needs in having a successful vaginal birth. There are exceptions to everything of course. I encourage you all to do the research yourself and see what you come up with.
If you wish to have an unmedicated childbirth, consider taking action ahead of time! Consider hiring a midwife in a birth center or for a home birth. You drastically reduce your chances of asking for anesthesia if there’s none around! Hiring a doula will also reduce your chances of epidural in any situation. According to Childbirth.Org, having a doula will reduce your risk of requesting an epidural by 60%. I also strongly encourage childbirth education classes where you can learn coping techniques for your birth.
Above all, have a beautiful birth and make it exactly what you want it to be.
CephaloPelvic Disproportion: AKA Will my baby fit through my pelvis? 11/10/2007 Danielle Griffin
I wanted to write about this because I am a bit shocked as to how many women I've met whose physicians have told them they have cephalopelvic disproportion, OR they think they can't push a baby through their pelvic bones and out of their vagina because they themselves are of a small size. Let's start by clarifying- Cephalopelvic disproportion (CPD): A baby having a head too large to fit through the mother's pelvis- therefore causing her to need a cesarean. CPD does exist, but it is far more rare than people think.
Let's start with some common misconceptions.
Misconception:
If one of my babies was delivered via cesarean birth due to CPD, all of my babies will be CPD.
Truth:
While it may be possible that CPD is due to an abnormally shaped pelvis which can make it difficult to ever be able to push a baby out (rare indeed-and still wont necessarily mean you have CPD), most reasons a woman is diagnosed with CPD is 1. A very large baby that is having a hard time coming through the pelvic bones, and 2. stalled labor (which can be normal for SO many reasons and still turn into a CPD c section).
Now, the truth of the matter is simply this: Every baby will have his/her own birth. Every baby is going to be a different size and have a different sized head. Every baby will mold differently while coming through the birth canal. I think it's a little known fact (I could be wrong- but I didn't know in the beginning with my first son!), that a babies head is made up of five plates rather than one bony structure. The plates overlap one another while the baby is being pushed through the birth canal, and UNTIL labor is happening, there is not really a true way to tell if your baby will fit or not (which it most likely will- even sometimes if you've been told otherwise).
Misconception:
If you are a small woman, you will have a harder time pushing a baby out and are more likely going to have CPD.
Truth:
Au contraire, my good friends. I have a fantastic example of this (and actually the inspiration for writing this article).
I had a doula client that was a very small woman. She is probably a good 4'10". She seemed sure that she could push out her baby, and yet others were questioning her ability. People were saying things such as- "you're so small, don't you need a c section?" Shame shame- not only are these people undermining this woman's ability to give birth, but they are planting seeds of doubt within her that could cause her to question herself. Women generally (and when I say generally I mean really MOST of the time) grow a baby that will be capable of being born to their mothers. It's really a great design...
Any who, I wanted to note that this woman called me in labor one morning. She didn't realize she was in labor and sounded like she was calling to let me know that something weird was happening (but she wasn't convinced). I told her to contact her midwife to go in and have her fluids tested (I was under the impression her water broke). She had an appointment with her m/w within a couple of hours. (Just fyi- she said her contractions were 20 seconds long and 10 minutes apart- she's a first time mother and I assumed we'd have a baby late in the evening or early in the morning. You know what they say about assuming...).
I figured I would call her around five in the evening if she hadn't called me back needing me. I realized I had a voicemail at around three. The baby was born after 1 (she had arrived to see if the fluid was really fluid at noon!) This very tiny first time mother's baby practically fell out! And people doubted her ;)
The point is your size does not matter one bit for the most part. A small woman CAN give birth vaginally.
On an end note, I'd like to post a clip written by ICAN (international cesarean awareness network), and published by Midwifery Today:
"Women have commonly been denied trials of labor if their first cesarean section was performed for failure to progress or cephalopelvic disproportion, the most common indications for primary cesarean. In a 1987 study published in the American Journal of Public Health, the largest percentage of women attempting VBAC had cephalopelvic disproportion or failure to progress cited as the primary indication for their initial cesarean. Of these women, 65 percent--almost two thirds--went on to have normal births; many of the babies were much larger than the baby for which the original cesarean section had been performed.
-ICAN Clarion, Sept. 1997
Reprinted from Midwifery Today E-News (Vol 1 Issue 50, Dec 10, 1999)
To subscribe to the E-News write: enews@midwiferytoday.com
For all other matters contact Midwifery Today:
PO Box 2672-940, Eugene OR 97402
541-344-7438, midwifery@aol.com, Midwifery Today"
Keep those babies coming ladies!
Blessings.
Ways to Have a Memorable Cesarean 9/19/2007 By Dani I wrote this a little while ago for a woman that was interested in what she could do to make her c-section more memorable with the help of a doula- or what the point of having a doula at a planned c section. She didn't want to have a c section, but unfortunately her child was breech and they'd done everything they could to turn her, with no avail. It's very difficult to find a physician willing to deliver a breech vaginally.
I hope this can help women who are having a c section against their want, or even women who choose to have a cesarean. I had to have one after 60 hours of laboring naturally at a birth center. I wish at that time I would have known more of this. I suggest even if you are not planning a cesarean birth to read this.
Here is a list of some things that can make cesarean birth more comfortable/ special. These things can be done by your partner, but I highly suggest having a doula. I think a lot of people forget that this is a birth for the father also, and when the father is expected to do all of the leg work, he can maybe feel like it's less about him and more about mother and baby (which are of course very important!)
*A doula can tell you what to expect during a cesarean birth, which can be invaluable. As someone who didn’t know anything about cesareans, I was deathly afraid of everything that happened to me because I didn’t know what was normal. Being in the know can make you more comfortable with what’s happening.
*Almost always they will let you play music in the operating room (this is something that I was completely unaware of until recently. I don’t think that they will offer it to you unless you ask. Perhaps you can play a song that you’ve sang to your baby during your pregnancy!)
*You can bring in some essential oils for aromatherapy during surgery. Peppermint oil is great for nausea, which is a common occurrence during cesarean.
*They will generally allow you to take picture of the surgery if you wish. If you are unsure, I would recommend doing it anyway. You can always throw pictures away, but you can never get the moment back.
*You can have your partner or a doula describe what’s happening during the surgery if you’re comfortable with that. It’s sometimes nice to know right when the baby is being born, and that they can see the babies head, and what color the hair is, etc.
*Once the baby is born, they will take he/she over to a side table to do their normal routines. It’s nice to have someone go over to the table with the baby and talk to him/her and let the baby know- we love you, welcome to the world, you’re beautiful, etc (don’t forget pictures!!!) The issue that arises when the father goes to do this (which isn’t a bad idea), is that the mother is left alone for part of the sewing up process. Cesareans are not comfortable, and it’s good to have someone doing your focus/breathing exercises during this (as well as throughout) surgery.
*A doula can advocate for you, and remind the staff that you’d like the father to hold the baby while the repair work is being done. She can also remind the staff that you would like to hold the baby as soon as humanly possible. They should be able to get the baby to you as soon as you’re out of surgery.
*A doula can also help you with breastfeeding if you’re a new mother. It can be trickier than it seems.
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